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Enhanced physiological tremor is the most commonly observed postural tremor. Physiologic tremor is undetectable, low amplitude and high frequency (10-12 Hz) tremor in normal individuals. Sympathetic hyperactivity causes enhanced physiological tremor that can be detected on observation.
Vertigo is a false feeling of motion caused by dysfunction of the inner ear or the central vestibular system. This is a common complaint from patients in a primary care setting and emergency room. A thorough neurological examination and history taking are crucial to narrow down the diagnosis. Physicians need to apply the correct bedside testing to the right patient to avoid unnecessary neuroimaging.
Abortive migraine therapy should be used as soon as possible after symptom development for maximum benefit; if abortive therapy is unsuccessful or used more than twice weekly, consider adding prophylactic therapy. Patients with nausea and vomiting may require nonoral medication. For all medications, consider patient comorbidities and contraindications.
Restless legs syndrome (RLS) (also known as Willis-Ekbom disease) is characterized by an intense crawling sensation deep inside the lower legs. Most cases are familial but can be secondary to an underlying illness. Management includes treating underlying diseases, nonpharmacologic therapy, and pharmacological therapy. Severe RLS may spread to the arms and significantly reduce the quality of life. This chapter discusses etiology, pathophysiology, clinical features, diagnostic evaluation, and management of RLS.